COM WEEK 13

Issues related to the measurement of activity & participation

What is measurement?
A number or score which reflects a pts status at the time it is assigned

What is assessment?
A qualitative and/or quantitative description of a pts status

What are some levels of measurement?

IMPAIRMENT: Loss or abnormality of physiological, psychological or anatomical
structure or function
Tests= ROM, pain, muscle strength
ACTIVITY LIMITATION/DISABILITY: Restriction or lack of ability to perform a
task/activity
Tests= sit to stand, 6MWT
PARTICIPATION RESTRICTION OR HANDICAP: disadvantage suffered
by indiv with ill-health due t inability to fulfil a role which is normal for someone of
that age, sex, culture

Why do we measure activity & participation?

• Determine functional abilities
• Design & monitor treatment

MEASUREMENT OF ACTIVITY LIMITATION:

Scales and questionnaires- Aim to find out the influence of specific impairments
on the ability to complete a functional activity
eg. Berg’s Balance Scale, Borg/RPE Scales, Motor Assessment Scale (MAS), Roland
Morris Disability Questionnaire (RM24)

MEASUREMENT OF PARTICIPATION RESTRICTION

Scales and questionnaires- Aim to measure the influence of disability on return to
life roles and ability to participate in society
Eg.Stroke-adjusted Sickness Impact profile (SA-SIP30), SF-36, McGill Quality of
Life Questionnaire

What are some important features?

1. Rating method
a. Self rated
b. Direct observation
c. Indirect
2. Summed vs hierarchical scales
3. reliability
a. consistent & free from error?
b. Intraclass correlation coefficient
c. Inter-rater
d. Intra-rater
e. Retest
 4. Validity
a. Measures what it is supposed to?
b. Face
c. Content
d. Criterion
e. Construct

How frequently do we measure?

Sensitivity of the scale
• its ability to detect change and rate of change of what you are measuring
Patient diagnosis and stage of rehabilitation

How do we choose an appropriate measuring tool?

Type of information you require
Tests of performance - good for quantifying a specific skill
 Scales/questionnaires –give information about generic functional ability
and about impact of things that cant be observed eg pain.
 Amount of time you have
 Reliability of tool
 Validity of tool
 Patient type
 Diagnosis - some tools are specific for a diagnostic group
 Patient severity